aldesleukin

Key Terms: Corticosteroids, Intravenous line, Kilogram, Lymphatic system, Metastatic, Milligram, Toxicity.

Definition

Aldesleukin is interleukin, or specific kind of biological response modifier, that is used to treat metastatic renal cell carcinoma (a form of kidney cancer) and meta-static melanoma. Aldesleukin is also known as interleukin-2, IL-2 and the trademarked name Proleukin.

Purpose

When renal cell carcinoma and metastatic melanoma (cancer of the skin that arises in the pigmented cells of the skin or eyes) do not respond to other therapies, they are candidates for treatment with aldesleukin.

Description

Aldesleukin is a biological response modifier (BMR). It promotes the development of T cells, or the cells in the lymphatic system that can fight cancer cells in cell-to-cell interaction. The human body produces aldesleukin naturally.

For use in therapy, aldesleukin is manufactured in a laboratory setting, using biotechnology methods, or methods that combine biological mechanisms and tools from technology. In the instance of aldesleukin, the compound is made in large quantities by using recombinant DNA technology. The DNA, or hereditary material, that provides instructions for making aldesleukin, is put in bacterial cells under laboratory confinement. The cells then produce large quantities of the human compound that are harvested, purified, and used for treatment.

Treatment with aldesleukin is considered palliative, which means it provides comfort but does not produce a cure. In some cases, aldesleukin is used together with an anticancer drug.

Recommended Dosage

Standard treatment with aldesleukin is via an intravenous line. The standard dose is 0.037 milligrams per kilogram of body weight every eight hours. For renal cancer, up to 15 doses can be repeated over 7-10 days every 5–6 weeks. But because the aldesleukin has such severe side effects, lower doses are being tried. And delivery of aldesleukin via an inhaler, or a mechanical device that puts the compound into the air passages when a person breathes, is being used in the case of metastatic melanoma that has invaded the lungs.

Precautions

Side effects from aldesleukin are generally very severe. No one who already has a metastatic growth in the central nervous system should take the treatment because aldesleukin will incite, or aggravate, symptoms from the tumor.

Side Effects

Aldesleukin causes changes in the ways body fluids accumulate in the body that can lead to ascites and pleural effusions. Changes in personality are common due to the influence the drug has on the central nervous system. Among the most severe side effects is the possibility a patient will slip into a coma, or unconscious state. Other side effects may include alterations in liver function, skin reactions, such as rash, and infections may be severe and life threatening. Less serious, and almost always transient side effects, include flu-like symptoms, such as nausea and vomiting.

Interactions

Aldesleukin interacts with drugs that affect the central nervous system and it should not be taken with drugs that are used to modify moods or disposition (psychotropic agents). Many drugs, including those used to control blood pressure, heart beat and kidney function, increase the toxicity of aldesleukin and should not be taken in combination with it. Corticosteroids also interfere with the action of aldesleukin.

Physicians must be informed about every drug a patient is taking so interactions can be avoided.

—Diane M. Calabrese

n

(interleukin-2, IL-2), trade name: Proleukin; drug class: antineoplastic; action: enhancement of lymphocyte mitogenesis and stimulation of IL-2-dependent cell lines; uses: metastatic renal cell carcinoma in adults.

Brand names: Proleukin®

Drug Forms:
• Aldesleukin, IL-2 injection (below)
• Aldesleukin Solution for injection

Español:
• Inyección de aldesleukina, IL-2
• Aldesleukina, Solución para inyección

Aldesleukin, IL-2 injection

What is aldesleukin, IL-2 injection?

ALDESLEUKIN, IL-2 (Proleukin®) is a type of chemotherapy for treating cancer. Aldesleukin, IL-2 can be used in combination with other medicines to treat acute lymphocytic leukemia, especially in children. Generic aldesleukin, IL-2 injections are not yet available.

What should I tell my health care provider before I take this medicine?

They need to know if you have any of these conditions:
• an immune deficiency (natural or due to chemotherapy, radiation, or steroid therapy)
• blood disorders
• an organ transplant
• fever or infection
• having intramuscular injections
• heart, lung, kidney, liver, or pancreas disease
• mental disorders
• seizures (convulsions)
• stomach or intestinal problems
• unusual bleeding problems
• an unusual or allergic reaction to aldesleukin, bacterial proteins, other medicines, foods, dyes, or preservatives
• pregnant or trying to get pregnant
• breast-feeding

How should I use this medicine?

Aldesleukin, IL-2 is usually administered by injection into a vein but can also be injected under the skin (subcutaneous injection). It can be given in a hospital or clinic setting by a health care professional. It is sometimes given at home.

What if I miss a dose?

This does not apply.

What drug(s) may interact with aldesleukin, IL-2?

• dacarbazine
• hormones such as prednisone or cortisone

Tell your prescriber or health care professional about all other medicines you are taking, including nonprescription medicines, nutritional supplements, or herbal products. Also tell your prescriber or health care professional if you are a frequent user of drinks with caffeine or alcohol, if you smoke, or if you use illegal drugs. These may affect the way your medicine works. Check with your health care professional before stopping or starting any of your medicines.

What should I watch for while taking aldesleukin, IL-2?

Aldesleukin, IL-2 may make you feel generally unwell. This is not uncommon. Report any side effects as above, but continue your course of medicine even though you feel ill, unless your prescriber or health care professional tells you to stop.

While you are using aldesleukin, IL-2 you will be more susceptible to infection. Try to avoid people with colds, flu, and bronchitis. Do not have any vaccinations without your prescriber's approval and avoid anyone who has recently had an oral polio vaccine.

Call your prescriber or health care professional for advice if you get a fever, chills or sore throat. Do not treat yourself.

Drink several glasses of water a day. This will help to reduce possible kidney problems.

What side effects may I notice from receiving aldesleukin, IL-2?

Side effects that you should report to your prescriber or health care professional as soon as possible:
• black, tarry stools
• blood in urine; dark yellow or brown urine
• changes in vision
• chest pain, fast or irregular heartbeat (palpitations)
• confusion, agitation, or hallucinations (hearing or seeing things that are not really there)
• difficulty breathing, wheezing
• dizziness, fainting spells
• fever or chills, cough or sore throat
• headache
• increased thirst
• increased or decreased amount of urine passed
• lower back or side pain
• mental delusions
• muscle, joint, or leg aches and pains
• seizures (convulsions)
• skin rash, redness, itching, or peeling, loose skin
• speech difficulty
• stomach pain or swelling
• unusual swelling, especially of the face, feet or ankles
• unusual bleeding or bruising, pinpoint red spots on your skin
• unusual tiredness or weakness
• vomiting
• yellowing of eyes and skin

Side effects that usually do not require medical attention (report to your prescriber or health care professional if they continue or are bothersome):
• constipation or diarrhea
• change in taste
• change in weight
• drowsiness
• dry skin
• indigestion
• loss of appetite
• nausea
• pain, swelling, or inflammation at the injection site
• sore mouth
• sweating

Where can I keep my medicine?

Keep out of the reach of children.

Last updated: 7/1/2002

Important Disclaimer: The drug information provided here is for educational purposes only. It is intended to supplement, not substitute for, the diagnosis, treatment and advice of a medical professional. This drug information does not cover all possible uses, precautions, side effects and interactions. It should not be construed to indicate that this or any drug is safe for you. Consult your medical professional for guidance before using any prescription or over the counter drugs.